Galectin-3 as a potential prognostic biomarker of severe COVID-19 in SARS-CoV-2 infected patients

  1. Eduardo Cervantes-Alvarez
  2. Nathaly Limon-de la Rosa
  3. Moisés Salgado-de la Mora
  4. Paola Valdez-Sandoval
  5. Mildred Palacios-Jiménez
  6. FĂĄtima Rodriguez-Alvarez
  7. Brenda I. Vera-Maldonado
  8. Eduardo Aguirre-Aguilar
  9. Juan Manuel Escobar-Valderrama
  10. Jorge Alanis-Mendizabal
  11. Osvely MĂ©ndez-Guerrero
  12. Farid Tejeda-Dominguez
  13. Jiram Torres-RuĂ­z
  14. Diana GĂłmez-MartĂ­n
  15. Kathryn L Colborn
  16. David Kershenobich
  17. Christene A Huang
  18. Nalu Navarro-Alvarez
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Abstract

BACKGROUND

Prognostic biomarkers are needed to identify patients at high-risk for severe COVID-19. Galectin-3 is known to drive neutrophil infiltration and release of pro-inflammatory cytokines contributing to airway inflammation.

METHODS

In this prospective cohort, we assessed galectin-3 levels in 156 hospitalized patients with confirmed COVID-19. COVID-19 patients were diagnosed as either critical (>50% lung damage) or moderate (<50% of lung damage) based on computerized tomography. Patients who required invasive mechanical ventilation (IMV) and/or died during hospitalization were categorized as having a severe outcome , and a non-severe outcome if they were discharged and none of the former occurred.

RESULTS

Elevated serum galectin-3 was significantly higher in critical patients compared to moderate ones (35.91 ± 19.37 ng/mL vs. 25 ± 14.85 ng/mL, p<0.0001). Patients who progressed to a severe outcome including IMV and/or in-hospital death, presented higher galectin-3 levels (41.17 ng/mL [IQR 29.71 – 52.25] vs. 23.76 ng/mL [IQR 15.78 – 33.97] compared to those of a non-severe outcome, p<0.0001). Galectin-3 discriminated well between those with severe and non-severe outcome, with an AUC of 0.75 (95% CI 0.67 – 0.84, p<0.0001) and was found to be an independent predictor of severe outcome regardless of the percentage of lung involvement. Additionally, the combination of galectin-3, CRP and albumin, significantly improved its individual predicting ability with an AUC 0.84 (95% CI 0.77 – 0.91, p<0.0001).

CONCLUSION

Circulating galectin-3 levels can be used to predict severe outcomes in COVID-19 patients, including the requirement of mechanical ventilation and/or death, regardless of the initial severity of the disease.

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